Antimicrobial Prescribing and Healthcare-Associated Infection Surveillance in the Province of KwaZulu-Natal, South Africa: Findings from The Global-PPS
Tracks
Meeting Room 1.63 - 1.64
| Monday, June 30, 2025 |
| 12:30 PM - 1:00 PM |
Overview
Speaker: Mrs Reshma Misra
Speaker
Mrs Reshma Misra
KZN Department of Health
Antimicrobial Prescribing And Healthcare-Associated Infection Surveillance In The Province Of KwaZulu-Natal, South Africa: Findings From The Global-PPS
Abstract
Background
Infection prevention and control (IPC) and antimicrobial stewardship (AMS) are hindered by limited resources in KwaZulu-Natal. We aimed to monitor antimicrobial prescribing and healthcare-associated infections (HAIs) in hospitals across KwaZulu-Natal to establish a surveillance baseline and enhance patient care.
Methods
We examined validated Point Prevalence Survey data of 49 out of 58 hospitals who participated in the Global-PPS from 2023 till 2024. Data covered all inpatients receiving antimicrobials on the survey day, with all admitted inpatients as denominator (http://www.global-pps.com).
Results
Out of 10,305 patients admitted to 287 wards in 2023–2024, 3,607 (35.0%) received at least one antimicrobial. Prevalence was slightly lower in 2024 (34.2%) than in 2023 (36.2%), with higher rates in child/neonatal wards (46.8%) compared to adult wards (31.8%). HAI prevalence also declined from 6.7% in 2023 to 5.5% in 2024. Among all 3,074 antimicrobials, antibiotics (86.6%), antifungals (5.4%), TB drugs (3.0%), and antivirals (2.9%) were used, with 46.8% prescribed for community-acquired infections and 24.9% for healthcare-associated infections (HAIs). Top antibiotics were amoxicillin/clavulanic acid (21.8%); ceftriaxone (10.1%), cefazolin (6.7%), metronidazole (6.1%).
Conclusions
Despite challenges, with strong leadership from the provincial level and facility teamwork, the Global-PPS was successfully implemented in KwaZulu-Natal. The results help verify patient safety incident reporting quality and assess alignment with Global-PPS data. This data supports policy advocacy, identifies hospitals with high HAI rates for onsite mentorship and guides care bundle prioritization. Daily surveillance of HAIs is now digitalized.
Infection prevention and control (IPC) and antimicrobial stewardship (AMS) are hindered by limited resources in KwaZulu-Natal. We aimed to monitor antimicrobial prescribing and healthcare-associated infections (HAIs) in hospitals across KwaZulu-Natal to establish a surveillance baseline and enhance patient care.
Methods
We examined validated Point Prevalence Survey data of 49 out of 58 hospitals who participated in the Global-PPS from 2023 till 2024. Data covered all inpatients receiving antimicrobials on the survey day, with all admitted inpatients as denominator (http://www.global-pps.com).
Results
Out of 10,305 patients admitted to 287 wards in 2023–2024, 3,607 (35.0%) received at least one antimicrobial. Prevalence was slightly lower in 2024 (34.2%) than in 2023 (36.2%), with higher rates in child/neonatal wards (46.8%) compared to adult wards (31.8%). HAI prevalence also declined from 6.7% in 2023 to 5.5% in 2024. Among all 3,074 antimicrobials, antibiotics (86.6%), antifungals (5.4%), TB drugs (3.0%), and antivirals (2.9%) were used, with 46.8% prescribed for community-acquired infections and 24.9% for healthcare-associated infections (HAIs). Top antibiotics were amoxicillin/clavulanic acid (21.8%); ceftriaxone (10.1%), cefazolin (6.7%), metronidazole (6.1%).
Conclusions
Despite challenges, with strong leadership from the provincial level and facility teamwork, the Global-PPS was successfully implemented in KwaZulu-Natal. The results help verify patient safety incident reporting quality and assess alignment with Global-PPS data. This data supports policy advocacy, identifies hospitals with high HAI rates for onsite mentorship and guides care bundle prioritization. Daily surveillance of HAIs is now digitalized.
Biography
Mrs Reshma Misra is a medical technologist, with considerable experience in all aspects of Medical Microbiology. She took a keen interest in education and training, policy development, quality assurance and participated in accreditation. She served on the Board of the University of Technology, Chairperson of the Microbiology Committee, assisted with College for Medicine South Africa exams and developed a Microbiology Training Manual for Student technologists and technicians.
Her interest in academia prompted her to complete the Bachelor of Medical Science (Honours): Infection Prevention and Control, for which she was admitted into the elite Golden Key and then the Master’s of Medical Science. She was awarded by the Infection Control Africa Network for recognition of original African research.
Reshma is currently the Assistant Director: Provincial Infection Prevention and Control – KwaZulu Natal, with 13 years of experience in IPC. She has contributed to the development of the section on hand hygiene in the Practical Manual for the Implementation of the National IPC Strategic Framework, developed many provincial documents and served on the national IPC technical working group.
